In our gastroenterology clinic from Jun. 2008 to Jan. 2009, 20. 9% (277/1320) patients were diagnosed with functional dyspepsia (FD) and 14. 8% (41/277) of them with psychological problems according to Minnesota Multiphasic Personality Inventory (MMPI). In those with psychological disorders,92.7% were found with somatization, 60. 9% with depression and anxiety, 97.6% with abdominal pain,75.6% with bloating, 63.4% with early fullness and 36. 6% with nausea. More than 80% patients with anxiety and depression complained irritability, worry, fatigue, poor concentration, memory loss and insomni.a. After 4 weeks of psychological consultation and anti-depression treatment, 5 patients had significant improvement, 31 had improvement and 3 had no response. The overall response rate was 87. 8%.In summary,there is a high prevalence of depression and anxiety in population with FD. Hypochondria and somatization are common among these patients. Psychological consultation with anxiolytic drugs may have good therapeutic effects.

Background and purpose:Drug resistance is a major cause of failure in lung cancer chemotherapy. This study aimed to investigate the effect of YAP on doxorubicin resistance in lung cancer and its underlying mechanism. Methods:Doxorubicin resistant lung cancer cell clones were established from parental sensitive cancer PC9 cell line via in vitroinduction, and the expression of YAP was analyzed. YAP was down-regulated via shRNA to different levels. MTS assay was employed to determine cell proliferation and drug sensitivity. Flow cytometry was used to determine cell cycle distribution, apoptosis and uptake of Rh-123. Western blot and quantitative real-time polymerase chain reaction (QRT-PCR) assay were used to determine the expression of ABCB1, ABCC1, p53, Runx2, ITGB2 and ErbB4. The phosphory-lation of serine/threonine kinase (AKT) was determined as well.Results:Doxorubicin resistant PC9/Adr cell clone was obtained with over-expressed YAP. Expression of YAP in PC9/Adr cells was down-regulated to different levels via shR-NA. After YAP silencing, cell proliferation was reduced, while sensitivity to doxorubicin was increased. The cell cycle was significantly halted by G0/G1 phase. Doxorubicin induced-apoptotic rate and cellular uptake of Rh-123 were increased,with positive correlation to YAP silencing level. Western blot and QRT-PCR results showed that after YAP silencing, ABCB1, ABCC1, Runx2, ITGB2, and ErbB4 proteins were down-regulated, while the expression of p53 was up-regulated. Phosphorylation of AKT was inhibited as well.Conclusion:Over-expression of YAP is involved in doxorubicin resistance in PC9/Adr cell line. Silencing of YAP could restore doxorubicin sensitivity. The mechanism involves regulation of drug resistance-related genes and promotion of apoptosis.

Tumor-associated macrophages (TAMs) mostly exhibit M2-like (alternatively activated) properties and play positive roles in angiogenesis and tumorigenesis. Vascular endothelial growth factor (VEGF) is a key angiogenic factor. During tumor development, TAMs secrete VEGF and other factors to promote angiogenesis; thus, anti-treatment against TAMs and VEGF can repress cancer development, which has been demonstrated in clinical trials and on an experimental level. In the present work, we show that miR-150 is an oncomir because of its promotional effect on VEGF. MiR-150 targets TAMs to up-regulate their secretion of VEGF in vitro. With the utilization of cell-derived vesicles, named microvesicles (MVs), we transferred antisense RNA targeted to miR-150 into mice and found that the neutralization of miR-150 down-regulates miR-150 and VEGF levels in vivo and attenuates angiogenesis. Therefore, we proposed the therapeutic potential of neutralizing miR-150 to treat cancer and demonstrated a novel, natural, microvesicle-based method for the transfer of nucleic acids.
Animals ; Carcinogenesis ; genetics ; metabolism ; pathology ; Cell Line, Tumor ; Exosomes ; HEK293 Cells ; Heterografts ; Humans ; Macrophages ; metabolism ; Male ; Mice ; Mice, Inbred C57BL ; MicroRNAs ; genetics ; metabolism ; Neoplasm Transplantation ; RNA, Antisense ; administration & dosage ; genetics ; Up-Regulation ; Vascular Endothelial Growth Factor A ; genetics ; metabolism

Objective To analyze the epidemiological characteristics of human brucellosis in northern and southern areas of China,and to develop national strategies for brucellosis prevention and control.Methods Individual data on human brucellosis was collected from the National Notifiable Infectious Disease Reporting Information System to describe the situation of brucellosis in China during 2015-2016.Epidemiological features of the disease in northem and southern areas of China were analyzed.Results A total of 104 125 cases were reported in mainland China during 2015-2016,with an average incidence rate as 3.81/100 000.The overall incidence rate from the northem provinces was 7.77/100 000 in 2016,a 18.6％ decrease from 2015 (9.55/100 000),whereas the incidence rate in the southern provinces was 0.27/100 000 in 2016,with an increase of 28.6％ than 0.21/100 000 in 2015.90.0％ of the newly infected counties mainly distributed in southern China.As for the locations of reporting cases,most of them were in the same counties in the northern areas (52.3％) while most cases in the southern areas (59.6％) were imported from other counties.The median age of the cases was 48 (IQR:38-58) years,with male-to-female ratios as 2.7 ∶ 1 in the north and 2.2 ∶ 1 in the south.Majority of the cases were occupation-related,from both the northern (86.8％) and southern (62.7％) areas.Human brucellosis occurred every month throughout the year but with an obvious seasonal increase between March and July.Conclusions Different epidemiological features of human brucellosis appeared in both northern and southern areas of China.The disease was seen endemic in the northem and dispersal in the southem provinces.Appropriate strategies for brucellosis prevention and control should be developed,according to the different epidemiological characteristics in the northcm or southcm areas.

Objective To explore the effect of sling exercise with Tuina therapy on kinesiophobia in old patients with lumbar disc herniation,and analyze the mechanism based on brain-bone axis. Methods A total of 56 old patients with chronic lumbar disc herniation and kinesiophobia were selected from the Reha-bilitation Hospital of the Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine from September,2022 to December,2023;and randomly divided into control group(n=28)and experimental group(n=28).The control group accepted conventional exercise therapy,while the experimental group accepted sling exercise with Tuina therapy,for four weeks.They were assessed with simplified Chinese version of Tampa Scale of Kinesiophobia(TSK),Japanese Orthopaedic Association score(JOA)and Visual Analogue Scale for pain(VAS)before and after treatment,while the bone mineral density(BMD)was tested,the levels of osteoprote-gerin(OPG),norepinephrine(NE)and corticosteroids(Cor)in serum were measured,and the median frequency(MF)of weak-link erector spinae was detected with surface electromyography. Results Two cases dropped off in the control group,and one in the experimental group.The scores of all the assessment improved in both groups after treatment(|t|>14.168,P<0.001),as well as the serum levels of OPG,NE and Cor(|t|>2.103,P<0.05),BMD(|t|>2.726,P<0.05),and MF of erector spinae(|t|>14.736,P<0.001);all of them were better in the experimental group than in the control group(|t|>2.154,P<0.05). Conclusion Sling exercise with Tuina therapy can improve the pain and kinesiophobia of lumbar disc herniation in the old adults,which may promote the recovery of physical and mental function through regulating the levels of hor-mones and neurotransmitters related to the brain-bone axis.

Objective To evaluate the current deployment of general practitioners and residents′utilization of services in China, for reference of their optimal allocation across the country. Methods The methods of HRDI and TOPSIS were used to comprehensively evaluate their deployment and residents′utilization of their services in China. Results General practitioners fall short of demand in general, averaging 0.137 1 GP per 1 000 population in China, with unbalanced regional distribution as well. Utilization of residents of general practitioners service remains at a low level, with unbalanced regional distribution as well. As shown in the comprehensive evaluation results, 87.10% of the regions were found with defective deployment and service utilization, featuring " low resources, low utilization" . Conclusions Sizable gapes are found between the eastern, the central and the western regions, in terms of allocation of resources and service utilization. The government should rationalize deployment of general practitioners and minimize such gaps among different regions, in view of local population, geography and health service needs.

The identification of clinical questions for clinical practice guidelines of Chinese patent medicine （CPM） is important for subsequent evidence retrieval， evaluation of evidence quality， formation of recommendations. This paper described a methodological proposal for the identification of clinical questions for CPM guidelines to highlight the characteristics of Chinese patent medicine and reflect its effect in specific stage of the disease. Considering four aspects， namely， the drug of Chinese patent medicine （D）， the specific disease stage （S）， comparison （C）， and specific outcome （O）， DSCO framework has been proposed to formulate the clinical questions. Multi-source information through scientific research， policy or standard documents， and clinical data are suggested for collecting clinical questions， and clear selection criteria should be set to finalize the clinical questions to be addressed by the guideline. In addition， the above process needs to be transparently and publicly reported in order to ensure the clarity and completeness of the guidelines.

The irrational use of Chinese patent medicines （CPM） is becoming more and more prominent， which makes the demand for clinical practice guidelines of CPM gradually increase. In order to make domestic scholars understand the latest developments and existing problems of the CPM guidelines， and promote its development， this paper introduced the concept of CPM guidelines， summarized the characteristics of the two development modes， namely “taking CPM as the key” and “taking disease/syndrome as the key”， and analyzed the current methodological status of developing and reporting CPM guidelines. Based on the existed problems， three suggestions have been put forward to optimize the quality of CPM guidelines， which were clarifying the target users and scope of CPM guidelines， establishing an open and transparent mechanism of the personnel involvement and process steps， and formulating implementable and operable recommendations for the use of CPM.